Validating HeartQoL for Ischemic Heart Patients

A recent multicenter research study published in the American Journal of Medicine Open has validated the use of the Greek version of the HeartQoL questionnaire as a reliable and valid instrument to measure health-related quality of life (HRQoL) for patients with ischemic heart disease (IHD).

The study establishes the applicability of the questionnaire in clinical practice and research and provides healthcare professionals with a culture-sensitive questionnaire that measures the physical and emotional status of patients with angina pectoris (AP), myocardial infarction (MI), and ischemic heart failure (IHF).

Ischemic heart disease is the number 1 killer in Greece, accounting for about 40% of all deaths. With improvement in survival due to advances in treatment, clinicians are paying more attention to patient-centered outcome measures such as HRQoL to inform treatment and measure recovery.

The trial was done at five clinical sites in Greece and engaged 158 adult patients with AP (n=53), MI (n=54), and IHF (n=51). The study population was asked to fill in a Greek HeartQoL questionnaire as well as the Short Form-36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale. Researchers assessed the psychometric characteristics of the questionnaire, such as internal consistency, factor structure, and validity.

The results were reliable, with Cronbach alpha values between 0.74 and 0.94 for the entire cohort. The HeartQoL questionnaire retained its original two-factor structure; Loevinger’s H coefficients above 0.50 were strong, and Mokken scale analysis was consistent with this structure.

Good convergent validity was noted, with the HeartQoL scores correlating well with the respective scales of the SF-36 (r=0.65-0.74 on the physical scale and r=0.51-0.61 on the emotional scale). The questionnaire also showed discriminative validity, effectively differentiating the HRQoL results in terms of diagnosis, age, sex, and psychosocial status.

It is important to note that patients with MI had higher HRQoL scores than those with IHF. Younger patients and male patients had better physical well-being and overall well-being, whereas older patients had better emotional scores. Floor effects were nonexistent and ceiling effects were negligible, which means that the questionnaire was sensitive to differences in responses of patients.

The Greek HeartQoL questionnaire is a reliable and simple instrument, as validated, which can assist healthcare professionals in evaluating the well-being of the patients with IHD and provide them with personalized care. It allows a clinician to assess the success of treatment not only along clinical dimensions but also according to the patient-reported outcomes and to individualize the interventions.